Organization
BAYSHORE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT KLUKOFF PSY.D. (PSYCHOLOGIST)
(813) 351-9235
Entity
Organization
Contact information
Practice address
15525 STARLING CROSSING DR, LITHIA, FL 33547-4021
(813) 351-9235
Mailing address
15525 STARLING CROSSING DR, LITHIA, FL 33547-4021
(813) 351-9235
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY8123
FL
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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